According to William G Allyn, Professor of Medical Optics in Rochester University, “More than 50 percent of the cortex, the surface of the brain, is devoted to processing visual information.“ Vision is such a dynamic element that involves an interplay of our brains.  It involves half of our cerebral cortex, the outer layer of the brain, to ensure our vision.  For those who can see images through their eyes, our brain works within an extraordinarily complex relationship to ensure we understand what we see and perceive readiness to move accordingly if need be.  Our minds are primed for visual content as long as we are able to see.   

We absorb what our environment presents to us and formulate a cursory understanding of what we need to do.  However, some content on our screens hijacks that process and allows our body to flood with neurochemicals and respond by shifting away from the parasympathetic relaxed state to the sympathetic arousal state.  This content augments our understanding of our world and reshapes our associations around us to present a high-stress environment. If we have visual acuity, that is to say, if we are able to see with or without visual aids, we are susceptible to the content inundating our screens. 

What is Screen Addiction?

Dr. Ranjit Singh, a Department of Electronics Communication Engineer at Ajay Kumar Garg Engineering College, India, elucidates in his article, “Peris of Screen Addiction” (2022),  

“Screen addiction is similar to addiction to drugs, gambling, and alcoholism. It doesn’t injure health like alcohol, nevertheless its ‘toxicity’ affects sub-consciousness and relationship with the world.”   

He goes on to report,  

“Dopamine levels rise when we’re just about to find reward and diminish after we receive it. Resultantly, to get us to do anything, evolution uses this chemical process to induce anticipation, motivation, and pain alleviation. Based on this phenomenon, technology giants like Apple and Google spent decades commercializing our attention and advancing addictive design. When one is favored by luck, dopamine gets released. For example, look at the randomness of the Facebook feed. All social media apps today use “digital confetti” to give you what you want at random intervals. The power of the dopamine system is experienced by drug addicts and smokers. Habit-forming drugs affect the dopamine system by dispersing it more and more than usual. Overusage is end result of wanting more and more pleasure to feel normal.” 

A significant correlation emerged between depression, self-esteem, and internet addiction.” (Bahrainian, SA, 2014). A 2015 study of 319 university students at Süleyman Demirel University “revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores” (Demirci, K, et al, 2015). Another study performed in 2018 examining 5003 Korean adults aged 19-49 conducted by the Catholic University of Korea Identified, “Internet addiction (IA) and smartphone addiction (SA) exert significant effects on depression and anxiety…Another interesting finding was that SA exerted stronger effects on depression and anxiety than IA.

This leads us to speculate that IA and SA have different influences on mental health problems. (Kim, Y., et al, 2018).  Lastly, for the sake of a smaller section examining the influence of smartphone and internet addiction, a study of 1103 adolescents aged 13-17 in Lebanon identified that “40.0% had occasional/frequent problems, and 3.6% had significant problems because of Internet use. The results of a stepwise regression showed that higher levels of aggression, depression, impulsivity, and social fear were associated with higher internet addiction whereas an increased number of siblings and a higher socioeconomic status were associated with lower internet addiction. (Sahar, O., et al, 2019).   

Smartphone usage has also been shown to affect our sleep and productivity.  

“Late night use of smartphones for work may interfere with sleep, thus leaving employees depleted in the morning and less engaged during the workday.”. (Lanaj, K., Johnson, R. E., & Barnes, C. M. 2014) 

What can we do to stem the tide of screen compulsion? 

While researching, for my book, The Visual Diet, I came across different methods to tend to screen compulsions. Many temporarily halt access to content while having a simple way to bypass it. Currently, smartphones have a “Do Not Disturb” feature that is just a click away. These are helpful if the individual has the bandwidth to ride the wave of compulsion.  

When others just cannot make the decision for themselves, additional apps may be needed to block problematic apps while still being able to use the phone. For Android users, the Lock Me Out app has this capability while iPhone users could use Opal.  

There is another method that could be beneficial for many, and it’s quite simple: change your screen color to grayscale. Black and white. Sounds simple and it is. Personally, I found some interesting benefits to it. Since we are more prone to experience the world enriched in vibrant colors, the attention to the surrounding experience can shift to provide more dopamine from our surroundings.  

I even took it a step forward and put all my screens in grayscale for the whole day, every day for a week now. Now, when I walk my dog, the colors around me feel much more vibrant. Coming from someone who has color-deficient vision, it has allowed me to reexperience the world with more beauty. My hope is that this could do that for you as well. I don’t plan on continuing forever, except for my phone, but will reengage with grayscale when I need more focus.  

References 

Rochester review :: University of Rochester. (n.d.). https://www.rochester.edu/pr/Review/V74N4/0402_brainscience.html 

Singh, R. (2022). Perils of Screen Addiction. AKGEC International Journal of Technology, 13, 40-44. 

Bahrainian SA, Alizadeh KH, Raeisoon MR, Gorji OH, Khazaee A. Relationship of Internet addiction with self-esteem and depression in university students. J Prev Med Hyg. 2014 Sep;55(3):86-9. PMID: 25902574; PMCID: PMC4718307. 

Demirci, K., Akgönül, M., & Akpinar, A. (2015). Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students, Journal of Behavioral Addictions, 4(2), 85-92. doi: https://doi.org/10.1556/2006.4.2015.010 

Kim, Y. J., Jang, H. M., Lee, Y., Lee, D., & Kim, D. J. (2018). Effects of internet and smartphone addictions on depression and anxiety based on propensity score matching analysis. International journal of environmental research and public health, 15(5), 859. 

Lanaj, K., Johnson, R. E., & Barnes, C. M. (2014). Beginning the workday yet already depleted? Consequences of late-night smartphone use and sleep. Organizational Behavior and Human Decision Processes, 124(1), 11-23. 

Obeid, Sahar PhD∗,†,‡; Saade, Sylvia PharmD§; Haddad, Chadia MPH∗; Sacre, Hala PharmD∥,¶; Khansa, Wael MD#; Al Hajj, Roula MSc†; Kheir, Nelly MSc∗∗; Hallit, Souheil PharmD, MSc, MPH, PhD¶,#. Internet Addiction Among Lebanese Adolescents: The Role of Self-Esteem, Anger, Depression, Anxiety, Social Anxiety and Fear, Impulsivity, and Aggression—A Cross-Sectional Study. The Journal of Nervous and Mental Disease 207(10):p 838-846, October 2019. | DOI: 10.1097/NMD.0000000000001034 

 

 

Addiction is an attachment disorder.  Human beings, addicts or not, only know and repeat what was modeled for them during childhood.  I like to call ages 0-10 healthy narcissism given that the world, as it should, revolves around the child.  If the child is not fed, he/she will be hungry; if the child is not given shelter, he/she goes without shelter; and if the child’s diaper is not changed, he/she will be wet.  Moreover, if, for example, the child’s parents divorce, who is at fault in the child’s mind?  Obviously, given that the world revolves around the child, the child believes he or she is to blame.  ‘If I just would have cleaned my plate’, ‘If I would have been a better boy…’, ‘If I just would have kept my room clean.’  These types of messages form the messages or models for future behavior of the child.    

 Part I of this article provided a definition and basic framework for Attachment Theory. Attachment theory provides that most individuals did not grow up with a model for secure attachment; thus, treatment for addiction requires providing a model of secure attachment so that individuals can practice healthy behavior in response to pain and discomfort other than acting out in addictive behavior.    

Theoretically, Mary Ainsworth PhD (1969) defined secure attachment as developing when a caretaker shows awareness of a child’s emotions and quickly attends to the child when distressed.  The child’s perception is that the caretaker is consistent in presence and provision; thus, the child feels safe in exploring their world because of their sense of certainty that their caretakers will be there for them in a nurturing manner if needed.  Overall, attachment theory assumes that the experiences of childhood relationships shape adult attachment style; thus, for example, the reason why adults who were physically abused as children have a high propensity for abusing their children.  This is the behavior that was modeled and typically the only mode that the adult has for responding to anger. 

The Scientific Link Between Attachment and Addiction: 

Attachment theory posits that an infant learns necessary skills for survival and the development of an Internal Working Model (IWM) whereby the definition of how the person views the world, themselves, and others is defined.  “Attachment representations show predictive associations with a wide range of pathological behavior including personality disorder(s), mood disturbance, [substance dependence] and psychopathology” (Caspers, Yucuis, Troutman, & Spinks, 2006).  Therefore, the authors conclude that childhood attachment styles (secure or insecure) have a direct impact on the prevalence of Substance Abuse Disorders.    

Researchers Kendler and Prescott (2006) reviewed the findings of the Virginia Twin Study of Adolescent Behavioral Development (VTS) for the purpose of exploring the depth of influence between genetics and environment as it relates to addictiveness and mental health disorders.  VTS had a sample size of 2,762 white twins between the age of 8-16 years old and their families.  Kendler and Prescott concluded that there are no genes specifically responsible for Substance Use Disorder, but rather, there are genes that an individual can inherit that predispose them to patterns of behavior closely associated with Substance Use Disorder.  Additionally, the authors concluded that if children are brought up in “protective environments”, even though genetically they are predisposed to patterns associated with Substance Abuse Disorder, the environment has a likely potential to be a protective factor against Substance Abuse Disorder.  

The Brain: 

Finally, researchers have directly correlated neurobiology of the human brain and the importance of caregiver attachment relationships during childhood to mental health in adulthood (Miehls, 2011, p. 82).  Additionally, the research has indicated that insecure attachments during childhood affects, negatively, the development of certain areas of the brain.  Moreover, Miehls states “relationships have the capacity to rebuild certain parts of the brain that influence our social and emotional lives,”) (Miehls, p. 81).   

 The benefit of the connection between neurobiology and attachment is that brain neuroplasticity (the ability of the brain to be re-formed) allows for a corrective experience or secure attachment model during adulthood leading to positive changes in the patient; thus, lessening the need to utilize addictive behavior to deal with abandonment, trauma, abuse, and emotional pain etc.  Moreover, the implication for treating substance dependence indicates the importance of a secure attachment relationship between the clinician and the patient to provide a baseline model or definition.   

Addiction as an Attachment Disorder 

The attachment system of a person is developed as a child in proportion to the relationship between the child and the caregiver; thus, if the attachment process is deficient, the child will have issues related to emotional regulation.  Therefore, as an adult, the person is likely to utilize drugs and other substances to regulate emotions as a means of adapting to an inability to regulate emotions learned as a child (Kohut 1977).   

Drugs create an ability for a person to have the illusion of self-esteem, self-confidence, worthiness and “increase feelings of being alive” (Kohut 1977).  An addict attempts to define comfort and security (missing in their vocabulary) through the use of addictive substances or behavior; however, outside sources other than secure modeling will lead to continued dysfunctional definitions and continued addictiveness.   

Treating Addictiveness and Substance Dependence through Attachment Theory:  

Recent studies have positively confirmed that a direct link exists between insecure attachment and substance dependence (Schindler, Thomasius, Sack, Gemeinhardt, 2007; Schindler, Thomasius, Sack, Gemeinhardt & Eckeert, 2005).    

“Attachment Oriented Therapy” (AOT) has been described as “a way of eliciting, integrating and modifying styles represented within a person’s internal working model” Flores (2004) p. 214).  Flores (2001, 2004) goes on to explain that the IWM must be changed or addiction will continue or substitution of one addiction for another will persist.  The key point is that when an individual begins to learn (which requires a model) how to self-soothe, thus, learning how to regulate emotions and feelings, they will avoid seeking outside sources as a means of managing these emotions (Blaine & Julius, 1977; Flores, 2001; Flores, 2004).  

The vast majority of individuals in treatment today have been exposed, multiple times, to the treatment experience; Therefore, what is missing?  Why the extreme difficulty in remaining sober?  Haven’t they been taught well?  Has the education system (the treatment industry) failed them?  The answer is not black and white, but rather, exists within the statement:  We must begin to treat patient’s differently.  The idea that we are able to teach patient’s how to stay sober doesn’t equate to their ability to apply what they have learned or feel safe enough to explore the deeper problem of why they continue to utilize addictive behavior to escape emotional pain. 

AOT is rooted in providing a “secure base” for an individual so that they may begin to explore themselves from the inside out.  Attachment theory correctly posits that by providing a model in treatment of a safe, secure base, the patient will have the ability to cease seeking answers outside themselves (drugs, alcohol, sex, food etc.) and begin to heal from the inside out.  Moreover, by providing this safety, patient’s have the ability to express and feel emotions in a vulnerable and authentic capacity; thus, the willingness to address the problem, rather than the solution (the addictive behavior).    

“A Different Way to Treat People”  

Conclusion 

Overall, what is missing in treatment today is the understanding and compassion of being relational with patients.  The irony in this statement is that AA promotes compassion and being relational with individuals; however, this is the part that most traditional treatment misses. Alternatively, traditional treatment provides an education as opposed to modeling behavior that provides the ability to develop secure attachment needed for change.   

Unfortunately, most addicts (probably most human beings in general) have not had a model for secure attachments, thus, leading to substance abuse and addictive behavior as a means of avoiding emotional pain. For treatment and thereafter, AA and therapy to be effective, the following suggestions are necessary: 

1. Treatment must be focused on modeling secure attachment.  This requires risk on the part of the treatment provider and a demonstration of self-disclosure and identification from the treatment team as opposed to a one-up position of authority; 
2. Development of trust and alliance with the patient is critical if the patient is going to address and change learned abusive and dysfunctional patterns during childhood; thus, leading to the need to utilize addictive behavior as a means of avoiding emotional pain; 
3. Continuation of care is critical.  Thirty days in treatment merely scratches the surface.  Without a long-term aftercare plan, i.e., Partial Hospitalization, Intensive Outpatient and therapy, that focuses on abuse, attachment, and secure attachments, we can expect relapse rates after inpatient treatment to remain near 5-7% within one year of inpatient treatment; and 
4. “A different way to treat people” must become the norm as opposed to the exception in treatment. 

 

“what am I missing; I keep relapsing and don’t know why I have such a difficult time remaining clean and sober?” 

 How we treat addiction in treatment must change.  The idea that we can provide information and teach an individual how to remain clean and sober is a fallacy.  Most addicts and alcoholics are above average in intelligence and the question is “Don’t you think if they could be taught how to stop destroying their life they would merely read a book and the problem would be eliminated?”  The answer is “Of Course.” Who would choose to drink, drug, or addictively act out knowing their life is over if they do?”  Nobody.  Thus, people know and they still partake in these behaviors.   

 Therefore, the answer is not merely education.   

Facts: 

• 9% of the U.S. population meets the criteria for substance use disorder (SUDs) (Substance Abuse and Mental Health Services Administration 2010); 

• Drug-related suicide attempts increased by 41% from 2004-2011 (Drug Abuse Warning Network (DAWN);

• Therapeutic alliance is one of the greatest predictors of positive treatment outcomes (Straussner, 2012). 

“Until an addict or alcoholic develops the capacity to establish mutually satisfying relationships, they will remain vulnerable to relapse and the continual substitution of one addiction for another (Phillip Flores)  

What is Attachment Theory? 

“Most of the psychopathology seen in the alcoholic is the result, not the cause of alcohol abuse.” (Valiant, 1983). 

If we don’t begin treating the problem, which quite possibly stems from a lack of secure attachment modeled during childhood, as opposed to the solution, addictive behavior, we can count on continued treatment failure, often called resistance to treatment.  Resistance to treatment seems to be a way of saying it’s the patient’s fault not ours.  Therefore, we put the cart before the horse. 

The result of putting the cart before the horse is the following: 

• We admit a patient to treatment with distorted definitions of concepts learned as a child, i.e., honesty, hope, faith, courage, integrity, willingness, humility, brotherly love, discipline, perseverance, awareness, service 

• The patient learned these definitions from their caregiver or parent from the models presented to them as children.   

• How would the patient know these definitions are potentially dysfunctional if it is all they know?

• How effective will step work be if the patient doesn’t have a model or healthy definition of what the principles of the steps espouse?   

Attachment theory assumes that the experience of childhood relationships shapes adult attachment styles.  These experiences create the road map or internal working model for how the individual will perceive himself and others relationally (Bowlby, 1973).   

The basic premise is that we only know what we know.  For example, two men are sitting in the park discussing zoo animals.  The one man asks the other if he has ever seen an elephant, to which the other man replies ‘no, what does it look like?’  The man states, ‘it is a large grey animal that has four hoofs, rough skin, floppy ears and trunk in the front’.  The other man states ‘you mean like the tree trunk outside?’  The man replies ‘no, not a tree trunk’.  To which many asks ‘You mean like the trunk of my car?’  The point is that the man will only know what an elephant looks like if he sees a picture or goes to the zoo.  Similarly, if a child grows up with caregivers who are physically present although not emotionally present, thus, lacking a functional definition of emotional availability and intimacy, the child is more likely to have a stunted view of being emotionally present for others in their life.  It is very possible that when this child becomes an adult, their innate need for secure attachment will not be met unless they see a model of what healthy attachment looks like. 

The basic principle of Attachment Theory is that those with secure attachment (stronger emotional relationship with caregiver) are better able to regulate emotions and have fewer relationship problems.  However, disruptions in the attachment system (insecure attachment) can lead to vulnerabilities in the sense of self and others as well as relationship problems; thus, leading to shame, co-dependency, and a need to numb pain via addictive behavior.  Therefore, if we don’t address and model secure attachments to patients, they will stay stuck in the solution of continuously seeking to avoid and discharge pain through addictiveness.   

 Research suggests that relationships influence brain development and “relationships have the capacity to rebuild certain parts of the brain that influence social and emotional lives; clinicians can help clients to alter their attachment patterns with a secure clinical relationship.  (Miehls, 2011, p. 82).   

The bottom line in defining Attachment Theory is that the goal of treatment needs to be focused on changing the definition and model of what it means to feel included, loved, and secure.  “The inability to establish healthy relationships is a major contributing factor to relapses and the return to substance use.”  (Flores, 2004).  Thus, the answer to “sh*t what am I missing?” is: Not having had a clear model of secure attachment because it was partially or completely missed during childhood.  As Flores stated: 

“Therapists must be able to challenge, soothe, care, love, and if necessary, fight with a patient if they are able to provide a full range of emotional experiences that can potentially come alive in an authentic relationship. (Flores, 2004, p. 259).  

To sum up part one of this article, unless we provide a solid definition of concepts that we see as normal (based on definitions that were modeled) albeit dysfunctional and damaging, the way we work the 12 steps will be flawed and based on dysfunctional definitions, lacking much change in behavior.  Alternatively, we can utilize the 12 steps as a corrective experience by interpreting each step as follows: 

 Interpreting the 12 Steps from an attachment perspective: 

Step 1:     The experience of abandonment; 

Step 2:     Permission to hope; integration to others; 

Step 3:     Taking a risk (vulnerability) to attach 

Step 4:     Taking a risk to attune with self 

Step 5:     Taking a risk to attach to another person 

Step 6-7:  Correcting and repairing relationship with self 

Step 8-9:  Correcting and repairing relationships with others 

Step 10:   Personal responsibility for securely attached relationships in my life 

Step 11:   Solidifying a secure attachment to my Higher Power 

Step 12:   Increasing my ability to model securely attached relationships to others 

by St. John’s Recovery Place

How Does Addiction Affect Relationships?

Okay, let us be blatantly honest about this: addiction to drugs or other substances has never positively impacted a relationship. There are many costs associated with substance misuse and addiction: one of the greatest costs is relationships with friends and family. There are no healthy, functioning relationships maneuvering successfully through the realms of addiction and abuse.

Addiction Affects All Kinds of Relationships

Every relationship that comes face to face with substance abuse and addiction is bound to suffer tremendously. Romantic relationships where at least one partner is dealing with addiction likely include a great deal more conflict than most. Trust issues, hurt feelings, and anxiety can be side effects of substance abuse in a relationship — for either partner or for both. These issues slowly wear away at relationships, gradually leading to the dissipation of happiness that eventually leads to relational failures, and not just the romantic kind.

Addiction does not just hurt the person who’s battling it; it affects all aspects of their life, including family, friends, and lovers. Relationships will suffer because of substance abuse and addiction. Siblings grow angry with each other, mothers cry, fathers wrestle with helplessness, friends grapple with anxiety and confusion — all of them wishing they knew how to make it better. However, these relationships and personal hurts, can be healed with time, therapy, and the proper treatment.

Family therapy is an integral part of many drug and alcohol rehabilitation programs. Often, it is friends and family working together who convince their loved one it is time to get help. The trick is knowing how to guide someone to rehab without force.

How Do I Support Someone with Addiction?

It is painful to watch someone you love and deeply care about slowly pulled deeper and deeper into addiction. Substance abuse is painful not only for the person going through addiction but also for the people around them. We see our loved ones hurting, and we wish desperately to help them, without the slightest idea on how best to provide aid.

Our first instinct is often to intervene and lecture our loved ones out of anger and/or the desire to protect them from endangering themselves and others. But in the case of substance abuse, it is often best to take a step back and look at the whole picture before trying to help.

Pause Before You Take Action

If your love for this person is making you feel urgent, take a deep breath and let it also make you thoughtful. Before you jump the gun and decide to confront your loved one, you must understand that addiction is a delicate and complex issue. No one wants to be an addict, and, certainly, no one plans to fall into addiction. But many do become addicted, and sadly, some of them have a tough time coming to terms with that fact.

Before you talk to anyone about what is going on, you should take a little time to think about the situation and circumstances you are facing. This does not mean don’t confide in a close, trusted friend, but be careful about whom you choose to share your concerns with. Struggling with an addiction can be embarrassing for your loved one to admit; fewer people knowing the intimate details about their personal life may make it easier for them to transition into recovery. If it’s something everyone knows about, they may feel like all eyes are on them, just waiting for them to screw up. You’ll also want to be careful about whom you speak with because, although most people mean well, they can give damaging and detrimental advice that can harm your chances of successfully encouraging your loved one to try rehab.

Thinking Through the Situation

It can be a lonely and complicated road to intervention, but you can do it. And if you really feel as though you need to speak to someone about what is going on but want to ensure your conversation is confidential, you can always reach out to a therapist to ease some of the weight on your shoulders. They may even be able to provide you with some solid advice and resources.

The GoodTherapy registry might be helpful to you here: we have thousands of therapists listed with us who would love to walk with you on this journey. Find the support you need today!

Before you take the plunge into planning your intervention, take some time to consider these questions:

• When did you begin to recognize the signs of substance abuse?
• Have there been warning signs and significant stressors in your loved one’s life?

It may sound silly, but substance abuse shares many of the same side effects of stress and of other illnesses. It is essential to understand what is happening in your loved one’s life as best you can before you decide to take definitive action. This condition likely took time to develop; you’ll want to be sure you prepare yourself to speak with your family member or friend. You should not go into such a delicate conversation about change, addiction, and recovery like a bull in a china shop. Every person responds to criticism and concern differently, so you will want to keep that in mind as well before you stage an intervention.

Of course, there are many ways to do this. Since some of them may work well for you and your loved one (and others may not), be thoughtful and wise as you consider the possible ways to approach an intervention.

Planning an Intervention

First things first: know your audience! Yes, it is true that if your loved one is suffering from substance abuse and addiction, they are bound to be different from the person that you used to know. Thus, you will need to move forward with a working knowledge of who your loved one is now, as well as who they were before substance use took over their life. Once you are certain you are witnessing an addiction issue that must be addressed, reach out to other close friends and family of your loved one to see if they have noticed similar patterns and behaviors.

Get Support with Intervention Planning

Talking to a doctor or mental health provider about the issues you are seeing in your loved one and ask for their advice on your next steps. Begin to do some research on drug and alcohol rehabs in your area or further out. You want to be ready to recommend action steps.

Recovery treatment centers (RTCs) like St. John’s Recovery Place provide drug and alcohol rehab. Use our RTC directory to start looking at the options today!

How to Approach the Intervention

In the meantime, note specific moments when you notice your loved one is struggling with something or neglecting things they used to love. You can use this information to encourage them to seek something better, rather than to shame them. More often than not, people who are confronted in interventions are defensive. You don’t want to make them feel humiliated or accused or to give them the impression you are trying to coerce them into doing a specific thing.

You want to go into an intervention with as much knowledge as you can about substance abuse and rehab. You may not know exactly you’re your family member or friend is using, but you can become familiar with the basic structures of all addictions and substance use disorders to give your “arguments” sound foundational settings.

Planning an intervention can be overwhelming. There is a lot to consider, and you’ll need to talk to a lot of trustworthy advisors. Ensure you know as much about your loved one’s situation as you can. Have examples ready for them for you to bring up and look back on if they express interest, and most of all, move slow.

But What If It’s Urgent?

It’s true that in many substance abuse cases, time is of the essence. But you want your relationship with your loved one to be a pillar of support, something they can lean into as they begin to work through the process of accepting that they need help and eventually getting it in rehab. You do not want your loved one to shun your relationship because you spoke too harshly, made accusations and demands of them, or even issued ultimatums. Even though it is possible that tough love will be effective (which probably only is true in a small subset of the population) for getting them into rehab, what you want to be supportive, persistent, and loving, and seen as a reliable, listening ear. They will need you in their path forward.

This Isn’t a TV Intervention

You may need to hold a few intervention meetings with the same people where you all gently bring up the topic of substance abuse and recovery in the proximity of your friend. Be honest and upfront, but supportive and unforceful. Let them know you see them, that you want to help them, and that you are willing to work with them through the process no matter how long it takes. Slow and steady wins the race; a steady intervention system could be the key to getting your loved one into rehab on good, hopeful terms, rather than damaging or even losing your relationship in the fight about their need for recovery.

Be prepared to meet resistance and to highlight some of your causes for concern. You may not win them over in one session, but you can open the door for them to start becoming interested in recovery and considering what their lives may look like after they have beaten addiction.

It will not be easy. But it will be worth it.

How to Support a Loved One in Rehab

Good work! You did the research and took your time convincing your loved one they may need to try addiction rehab. You didn’t watch television shows on how to do it all, but offered your case with thorough thought, compassionate understanding, gentle concern, and strong, “I’m on your side” support. That is the way it should be done.

But your job is not over yet!

Now What?

Now that your loved one has enrolled in rehab, it is time for you to work even harder at this relationship. So, what can you do to support your loved one while they are in rehab? That can be a little tricky, but there are several ways in which you can show your support.

When it comes to inpatient rehabilitation, programs often severely limit the amount of outside exposure your loved one receives. Do not panic: This is a common practice aimed at helping addicts cull their desire to contact someone who can get them drugs or alcohol and encouraging them to build a new lifestyle for themselves. Even so, you may be able to show support to your loved one in recovery and continue working on healing your relationship by doing any or all of the following:

• Calling your loved one frequently while they are in rehab
• Engaging in family therapy sessions if you can
• Writing letters to your loved one
• Attending any in-person visit that you can at the rehab center
• Sending a small care package

Be sure you’re following the guidelines of the rehab center caring for your loved one — the last thing you want is to throw off the progress they’re making. If you have other ideas of how you can encourage and support your loved one, run them by the rehab. Keep in mind that during the inpatient healing process, your loved one must remain on campus grounds as much as possible in order to help them separate themselves from their old abuse habits. Addiction is scary and overwhelming, affecting everyone in its path. But recovery can also be challenging for the individual and their loved ones alike.

This Is a Temporary but Necessary Step

The recovery process may not be easy for either of you, but keep reminding yourself of how far you have already come! The effort you are putting into helping your loved one heal and working on repairing your relationships is well worth the rewards. And planning for inpatient and aftercare rehab for your loved one may keep you sane through the whole process.

After Rehab

If you’ll be continually supporting your loved one post-treatment, consider brainstorming a list of sober activities and fun ways to release stress that will help make life feel “normal again” in anticipation of discharge from rehab. Prepare for the best but have a contingency plan in place for the worst. There will be good days as well as bad days on the path to healing.

It is essential that you be ready to face whatever challenges may appear. Have a support network for yourself — to celebrate the triumphs, give you new ideas, and help you cope with the hard days. You’ll naturally want to have a long list of things you can do to help your loved one to readjust, but the best way to provide support post-rehab is simply to be there for your loved one. Listen. Show up for this relationship. Be their adventure buddy, even if your excursions are only to Walmart or a coffee shop. And always show understanding and kindness.

Rehab centers like St. John’s Recovery Place are tremendous allies in the fight to beat addiction. Be sure to reach out to therapists who specialize in addiction who can help you help your loved one and may be able to support them post-rehab.

Drug abuse is a serious health concern. Overdose-related deaths in the United States have reached epidemic level. In fact, the Centers for Disease Control and Prevention (CDC) estimate an average of 130 people die from opioid overdose each day. This number doesn’t take into account deaths related to other drugs, which may increase this number.

Any drug use can become dangerous. Marijuana, now legal for medicinal and recreational use in many states, may help relieve pain, chemotherapy side effects, and symptoms of mental health concerns such as anxiety and posttraumatic stress. Research has also suggested marijuana may help treat addiction in some people. But despite these potential benefits, it can become addictive and could have health effects such as short-term memory impairment, impaired brain function, and respiratory health issues, among others.

Recreational use of illegal substances, even short-term use, can have serious health effects, including anxiety, paranoia, depression, suicidal thoughts, hallucinations, nausea, increased heart rate and blood pressure, and more. There’s also a risk of death due to overdose or complications. Long-term use of certain drugs could increase risk of violent behavior and may lead to legal trouble. Abusing drugs can also lead to drug dependency, or addiction.

Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives.

If you’re experiencing addiction, you’re not alone. According to statistics from the Substance Abuse and Mental Health Services Administration, more than 20 million Americans experienced a substance abuse disorder in 2014. Addiction can be difficult to overcome, no matter how hard a person tries. Professional support, in the form of inpatient or outpatient drug rehab, can benefit many people living with drug addiction.

Myths about drug rehab are plentiful. If you’re considering rehab for yourself or a loved one, making sure you have all the facts will help you make a more informed decision. Here, we present five common myths about drug rehab and the facts to counter them.

Drug Rehab Myths and Facts

Myth: Only wealthy people go to rehab.
Fact: Anyone can go to rehab.

It’s true that drug rehab can become expensive. Some people may not even consider inpatient rehab an option, believing it to be out of their budget. But the cost of drug rehab can depend on a number of factors, and there are rehab options for a range of budgets. See our article here for a more detailed explanation of rehab costs.

Some drug rehab centers offer low-cost or sliding-scale fees, based on your income. According to the 2012 National Survey of Substance Abuse, 62% of rehab facilities charge based on a sliding scale. Facilities may also offer payment programs or other types of financial assistance to people in need. Many drug rehab centers accept insurance, though not all insurance providers cover rehab.

When considering rehab, talk to your insurance provider and the rehab facility you’re interested in to get a better idea of the cost involved. Some centers may be able to work with you or refer you to another quality center that is more affordable. If the cost of inpatient rehab is a barrier, you might also consider outpatient drug rehab programs.

Myth: Rehab is for when you hit “rock bottom.”
Fact: You can begin recovering from addiction at any time.

Many people go to rehab when no other treatment option has worked. Often, they’ve lived with addiction for many years. Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives. Research suggests early intervention helps improve treatment outcomes.

Addiction not only contributes to emotional and physical health concerns, it can also lead to homelessness, unemployment, debt, and breakup or divorce. Choosing to enter rehab when you first find yourself becoming dependent on substances can help you begin the recovery process before addiction can have more of an effect on your life.

Myth: Rehab is only for people who can’t quit on their own.
Fact: Anyone experiencing addiction can get help in rehab.

The idea that addiction only happens to weak or flawed people is widespread. It might seem logical: Many people experiment with drugs, but not everyone becomes addicted. But drug abuse alters brain chemistry and affects cognitive function, leading to cravings for the substance and eventually addiction. Certain factors, including genetics, can increase a person’s risk for addiction.

Although a person might choose to try drugs, they don’t choose to become addicted. Once addicted, many people can’t stop using drugs without professional help. Needing rehab isn’t a sign of weakness. Changes in the brain resulting from addiction can make it extremely challenging, if not impossible, to stop using drugs without the support of health care providers trained in addiction support.

Whether you’ve tried to stop using drugs and relapsed or are just beginning to realize you may have a problem with substance abuse, rehab can help you begin recovery.

Myth: Rehab will prevent a person from relapsing.
Fact: Relapse is common, but treatment can help reduce its impact.

Between 40 and 60% of people dealing with addiction will relapse, according to the National Institute on Drug Abuse. While rehab may help reduce your risk of relapse, completing a drug rehab program doesn’t guarantee you’ll never relapse.

But rehab still has benefit. Research shows rehab can help by helping you develop skills to resist cravings, making relapse less likely. If you do relapse, the length of the relapse may be shorter. People who participate in treatment programs such as rehab also tend to relapse fewer times than people who don’t. Rehab can also lead to improvements in your relationships with friends, family, and loved ones. Developing stronger bonds with people you care for can also decrease the likelihood of relapse.

Myth: Rehab doesn’t work if you force someone to go.
Fact: Rehab can work even if you don’t want treatment.

Some people choose to enter rehab on their own, but some people experiencing addiction may not see its effects on their life, or they may not believe they have a problem with substance abuse. They may only decide to enter rehab grudgingly, after a court order or intervention from loved ones.

Being issued an ultimatum or feeling otherwise “forced” into rehab could make some people resistant to treatment, at first. According to the National Institute on Drug Abuse, however, people who feel pressured to overcome addiction in order to maintain an important relationship or avoid criminal charges, for example, often do better in treatment, even though they didn’t choose to enter rehab on their own.

Substance abuse and addiction can have serious, lifelong consequences. But there is help. Drug rehab may seem like an extreme measure, but this is partially due to the many myths surrounding rehab treatment.

Numerous studies support the benefits of rehab for addiction recovery. Inpatient centers provide a safe place to begin the detox and recovery process at any stage of addiction. Some facilities are expensive, but it’s possible to find affordable centers that will work with you to find a treatment program that’s right for your needs and your budget.

Don’t let myths about drug rehab keep you from getting addiction recovery support. Compassionate care is available! Begin your search today at GoodTherapy. Recovery may be a lifelong journey, but you are not alone.

References:

1. American Addiction Centers. (2019, February 14). How much does rehab cost? Retrieved from https://americanaddictioncenters.org/alcohol-rehab/cost
2. American Addiction Centers. (2018, October 15). Rehab success rates and statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/success-rates-and-statistics
3. Blending perspectives and building common ground. Myths and facts about addiction treatment. (1999, April 1). U.S. Department of Health and Human Services. Retrieved from https://aspe.hhs.gov/report/blending-perspectives-and-building-common-ground/myths-and-facts-about-addiction-and-treatment
4. Centers for Disease Control and Prevention. (2018, December 19). Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
5. Leshner, A. I. (n.d.). Exploring myths about drug abuse. National Institute on Drug Abuse. Retrieved from https://archives.drugabuse.gov/exploring-myths-about-drug-abuse
6. Mayo Clinic. (2017, July 20). Intervention: Help a loved one overcome addiction. Retrieved from https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
7. Mayo Clinic. (2017, October 26). Drug addiction (substance use disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
8. National Academies of Science, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Retrieved from http://nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx
9. National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
10. National Institute on Drug Abuse. (2018). Is marijuana addictive? Retrieved from https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive
11. Substance Abuse and Mental Health Services Administration. (2015). Behavioral health trends in the United States: Results from the 2014 national survey on drug use and health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
12. Substance Abuse and Mental Health Services Administration. (2016). Early intervention, treatment, and management of substance use disorders. In Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK424859
13. Substance Abuse and Mental Health Services Administration. (2019, January 30). Mental health and substance use disorders. Retrieved from https://www.samhsa.gov/find-help/disorders
14. Walsh, Z., Gonzalez, R., Crosby, K., Thiessena, M. S., Carrolla, C., & Bonn-Miller, M. O. (2017). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review, 51, 15-29. Retrieved from https://www.sciencedirect.com/science/article/pii/S0272735816300939?via%3Dihub
15. Weber, L. (2015, July 11). How much does inpatient rehab cost? Retrieved from https://addictionblog.org/rehab/inpatient-rehab/how-much-does-inpatient-rehab-cost

It’s difficult to spend time in any women’s community, online or otherwise, without hearing a reference to retail therapy. In the popular press, shopping is gendered as a pursuit for women. So resources for people with compulsive buying disorder, sometimes called oniomania, often focus on women. The truth is that men, women, and people not on the gender binary can struggle with shopping addiction.

What Is Shopping Addiction?

Buying things is an inescapable part of life. Most people who can afford to do so make some unnecessary purchases. It can even be difficult to discern what constitutes an unnecessary purchase—are seeds or a rose bush really unnecessary to a dedicated gardener? These factors all make it difficult to separate typical shopping behavior from a shopping addiction.

Additionally, the Diagnostic and Statistical Manual (DSM-5) does not list shopping addiction or compulsive buying as a separate addiction. This makes diagnosis more challenging, especially for those who want to know whether they meet diagnostic criteria.

People who are addicted to shopping are often preoccupied with it. While most spend money, some simply think about or plan to shop. Some characteristics of shopping addiction as opposed to normal shopping include:

• Shopping that continually causes negative personal consequences, such as debt or relationship problems.
• Being preoccupied by shopping and spending time thinking about shopping instead of other pursuits.
• Feeling guilty or ashamed about shopping.
• Concealing purchases or shopping.
• Being unable to quit shopping or thinking about shopping.
• Continually using shopping to cope with negative emotions.
• Spending more money than one can afford.
• Consistently buying things that go unused.

Shopping addiction can have devastating effects on a person’s life. It may undermine their ability to make important purchases such as buying a home or funding college. It can cause them to drain their savings. It may lead to debt and bankruptcy or destroy relationships.

Because people who compulsively shop often do so to cope with stress, the stress of compulsive shopping can actually fuel more shopping.

People of all genders can experience an addiction to shopping or buying. Most research estimates that 6-7% of people worldwide compulsively shop.

What Research Says About Shopping Addiction and Women

People of all genders can experience an addiction to shopping or buying. Most research estimates that 6-7% of people worldwide compulsively shop.

Research on gender differences is mixed and inconclusive. A German study found equal rates of compulsive buying among men and women. A Spanish study arrived at a different conclusion, finding slightly higher rates of compulsive shopping among women.

Despite the fact that people of all genders may shop too much, 80-94% of people seeking treatment for compulsive buying are women. A 2016 analysis argues that this may not be because of gender differences in shopping style. Instead, this may be due to an increased likelihood that women will recognize and seek help for a problem with shopping.

A 1997 article analyzed compulsive shopping among women through a feminist lens. That article argues compulsive shopping is often compensatory in nature. Compensatory consumption is an attempt to overcome perceived or actual deficits in status, relationships, or self-perception. In a sexist society, the article argues, compensatory consumption may be one way women cope with gender inequity.

Culture, Family, and Genetics: What Leads to Shopping Addiction?

Like other mental health issues, no single factor has been proven to cause all cases of shopping addiction. Shopping addiction is a complex mental health challenge that may be caused or exacerbated by numerous factors.

While some analysts speculate that compulsive shopping may be genetic, no research has found a clear genetic link to compulsive buying. However, many people who shop compulsively have another mental health condition such as depression or anxiety. These diagnoses do have genetic underpinnings, so genetics could play an indirect role.

Despite a dearth of genetic research, compulsive shopping sometimes runs in families. This may be because parents and other caregivers model to children that shopping is a good way to relieve psychological distress.

Some other factors that may play a role in the development of compulsive shopping include:

• Living in a market economy in which numerous purchase options are available.
• A materialistic outlook.
• Low self-esteem or a weak sense of identity.
• Access to credit cards or to enough disposable income to compulsively shop.

Brain imaging scans of people with behavioral addictions, including compulsive shopping, have found differences in several regions of the brain. Those include the limbic system, which plays a role in memory and emotion, and various areas of the brain associated with reward and motivation.

Why Do People Become Compulsive Shoppers?

Most research suggests that people who shop compulsively do so to alleviate feelings of boredom, anxiety, sadness, depression, and other painful emotions. In some cases, people shop to alleviate discomfort caused by shopping itself. For instance, a person who receives a large credit card bill may try “retail therapy” to cope.

People who use shopping to deal with psychological pain are more likely to have certain personality traits. Those include:

• Impulsiveness
• Compulsiveness
• A high sensitivity to rewards
• A desire for novelty and excitement

For When You Can’t Stop Shopping: Overcoming Shopping Addiction

Shopping addiction often happens in secret, but admitting you have a problem is the first step to recovery. Shopping addiction is not a character defect. It’s a real diagnosis that warrants real treatment.

Some people find relief from 12-step programs such as Debtors Anonymous. Others find that antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) help, possibly by alleviating underlying psychological symptoms. Most people with an addiction to shopping need therapy to help them quit.

Cognitive behavioral therapy, which helps people understand the connection between their thoughts, emotions, and behaviors, has proven particularly helpful for fighting compulsive shopping. Other forms of therapy may also help by:

• Supporting people as they manage painful emotions without shopping.
• Helping repair broken relationships.
• Offering emotional support for managing debt and other financial issues.

Shopping addiction is treatable, as are the many problems it can cause in a person’s life. For help managing an addiction to shopping, begin your search for a therapist here.

References:

1. Granero, R., Fernández-Aranda, F., Mestre-Bach, G., Steward, T., Baño, M., Pino-Gutiérrez, A. D., . . . Jiménez-Murcia, S. (2016). Compulsive buying behavior: Clinical comparison with other behavioral addictions. Frontiers in Psychology, 7. doi: 10.3389/fpsyg.2016.00914
2. Mattos, C. N., Kim, H. S., Requião, M. G., Marasaldi, R. F., Filomensky, T. Z., Hodgins, D. C., & Tavares, H. (2016). Gender differences in compulsive buying disorder: Assessment of demographic and psychiatric co-morbidities. PLoS One, 11(12). doi: 10.1371/journal.pone.0167365
3. Pinna, F., Dell’Osso, B., Di Nicola, M., Janiri, L., Altamura, A. C., Carpiniello, B., & Hollander, E. (2015). Behavioural addictions and the transition from DSM-IV TR to DSM-5. Journal of Psychopathology, 380-389. Retrieved from http://www.jpsychopathol.it/wp-content/uploads/2015/12/12_Art_ORIGINALE_Pinna1.pdf
4. Piquet-Pessôa, M., Ferreira, G. M., Melca, I. A., & Fontenelle, L. F. (2014). DSM-5 and the decision not to include sex, shopping, or stealing as addictions. Current Addiction Reports, 1(3), 172-176. doi: 10.1007/s40429-014-0027-6
5. Woodruffe, H. R. (1997). Compensatory consumption: Why women go shopping when they’re fed up and other stories. Marketing Intelligence & Planning, 15(7), 325-334. Retrieved from https://www.emeraldinsight.com/doi/abs/10.1108/02634509710193172

About 46% of people who once had an issue with drug or alcohol use achieved sobriety without formal treatment or assistance, according to a study published in Drug and Alcohol Dependence. The study found that addiction issues are common, with 9.1% of participants in a nationally representative survey reporting they had recovered from an addiction.

The study undermines some popular beliefs about addiction, particularly that all individuals recovering from addiction must see themselves as “in recovery” or seek inpatient treatment.

Many Pathways to Sobriety

The study began with a nationally representative survey of 39,809 people. Researchers followed up with 2,047 participants who answered in the affirmative to, “Did you once have a problem with alcohol or drugs but no longer do?” Some participants responded to follow-up questions incompletely or in ways that suggested they had not actually had an addiction. This left 2,002 responses to analyze. [fat_widget_right]

Slightly more than half (53.9%) of people who recovered from an addiction said they sought help to become sober. The most popular path to sobriety was through self-help groups like Alcoholics Anonymous. Around half (45.1%) of people in recovery used these programs to get sober. Medical treatment was another popular option, with 27.6% using some form of treatment in either inpatient or outpatient settings.

Recovery support services, such as faith-based programs and sober housing, helped another 21.8% of respondents become sober. About 37% used multiple forms of assistance to get sober.

The remaining 46% of respondents did not use traditional treatment or support to get sober. Just 46% of people who were once addicted to drugs or alcohol reported viewing themselves as “in recovery.” Many addiction treatment programs encourage people with substance abuse issues to see themselves as in recovery for a lifetime.

Authors of the study argue that this suggests there are many ways to achieve sobriety. Treatment providers might need to reconsider the way they talk about addiction and the way they encourage people in recovery to view themselves.

Who Seeks Treatment for Addiction?

The study also analyzed factors that correlate with seeking formal assistance to get sober. People who abused substances at an earlier age, who abused several substances, who were involved with drug courts, and who were diagnosed with a substance use or mental health issue were more likely to seek assistance to get sober.

People with opioid addiction were more likely to seek help, while those with an addiction to cannabis were less likely to pursue assistance.

References:

1. Almost half of those who resolve a problem with drugs or alcohol do so without assistance. (2017, November 01). Retrieved from https://medicalxpress.com/news/2017-11-problem-drugs-alcohol.html
2. Kelly, J. F., Bergman, B., Hoeppner, B. B., Vilsaint, C., & White, W. L. (2017). Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169. doi:10.1016/j.drugalcdep.2017.09.028

Anyone who has ever been in recovery from addiction or abuse can attest to the fact it is not easy. The process of recognizing there is a problem; increasing motivation to take control; seeking support; and identifying the types of people, environments, and situations that will allow for recovery may, at times, seem impossible. It is the difficulty of the work of recovery that makes recovery communities all the more important—in many cases, crucial.

What Are Recovery Communities?

Recovery communities are organized and structured support networks that focus on the specific issues and needs that are relevant to the participants. For those recovering from substance abuse, the recovery community may focus on understanding the urges and triggers surrounding substance use. The community taps the experience of newer and longer-term community members to foster support as well as key strategies to prevent relapse.

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In the instance of people recovering from sexual, physical, or emotional abuse, these communities provide a safe space for individuals to share and process their experiences; connect with others who have had similar experiences; and receive ongoing support to promote healing, self-confidence, and self-worth. They may also include a prevention aspect to help recovering people learn how to identify and avoid situations and environments that may be harmful. These communities can be broad or highly specific, virtual or in-person, open or closed.

Why Should I Join a Recovery Community?

Two of the most insidious issues with addiction and abuse are the feelings of shame and isolation that typically accompany those experiences. It becomes difficult to know who you can talk to, to know who is safe and who will provide support in helping work through things.

Recovery communities are a collection of people who are motivated both to promote their own recovery and to form relationships that decrease the sense of shame or isolation they faced because of the abuse or addiction.

Once you’ve identified yourself as someone in recovery, it becomes important to reengage with the world around you in new and different ways. For some people, this might mean finding new people to be around, people who help support and maintain habits you are adopting in your recovery.

Recovery communities are a collection of people who are motivated both to promote their own recovery and to form relationships that decrease the sense of shame or isolation they faced because of the abuse or addiction. Joining a recovery community allows those in recovery to connect with and help others. Knowing that your story and your engagement in a recovery community helps others through their own recovery process can have significantly positive effects on self-worth and self-efficacy.

How Do I Choose a Recovery Community?

First, it’s important to identify what you are recovering from. You are not limited to joining one recovery community. If, for example, you are recovering from intimate partner violence and substance abuse, you may find yourself part of two different recovery communities that focus on separate areas of recovery.

Second, consider what community of people you feel would be best suited to help you through recovery. You may decide you want to join a community with participants of the same gender identity or groups with a particular cultural understanding. Or perhaps you want to join a community that uses spiritual or religious practices that you want to incorporate into your life. Doing a little research on who is in the community beforehand may lead you to feel more comfortable when you join. It may also encourage greater participation and involvement within your chosen community.

Another key consideration when choosing a recovery community has to do with access and availability. Would you prefer a community that is local? While some people may prefer anonymity as they work through their recovery, others may enjoy knowing that members of their community are close by and readily accessible. Some community groups may be open, meaning new members might be able to join or drop by at any time. Other groups are closed or may have limited opportunities for new members to join.

Do in-person groups appeal to you or are you more interested in virtual communities? In-person communities allow you to be with people in real time but may be harder to attend because of physical or time restrictions, whereas virtual communities may allow you have greater access to members and get support during hours that an in-person group might not be available.

If you are interested in joining a recovery community and are already seeing a professional, they may be able to recommend a group for you. Well-known recovery communities include AA (Alcoholics Anonymous), Al-Anon (for family and friends), NA (Narcotics Anonymous), and RAINN (Rape, Abuse, and Incest National Network). If you are at the beginning stages of recovery, meeting with a mental health professional may be a valuable first step before entering a recovery community.